Strategies for Engaging Individuals in Tobacco Use Disorder Treatment
The Department of Health and Senior Services (DHSS) is offering a free webinar for primary and behavioral health care providers regarding Engaging Individuals in Tobacco Use Disorder Treatment. This webinar is November 16, 2023 from 12pm to 1pm CST. Register now to attend
The training is part of the DHSS Tobacco Cessation Health Systems Change Community of Practice (CoP) webinar series being presented by the Behavioral Health and Wellness Program, University of Colorado.
Retroactive Authorization for Behavioral Health Residential and Treatment Foster Care Services Ending October 1, 2023
Effective October 1, 2023, MHD will no longer approve retroactive prior authorization (PA) requests for residential (Qualified Residential Treatment Program (QRTP), non-QRTP, nonInstitution for Mental Disease (IMD) QRTP), and treatment foster care (TFC) services (TFC Level 1 and TFC Level 2).
Registered Behavior Technicians
On March 20, 2020, in response to the COVID-19 outbreak and due to the closure of testing centers administering the Registered Behavior Technician (RBT) exam, the MO HealthNet Division (MHD) published a provider hot tip temporarily waiving the RBT requirement for technicians who met all other requirements but had not taken the RBT exam.
Reminder of Precertification Requirements for Behavioral Health, Psychotherapy Services
Precertification is required for family, individual, and group psychotherapy (beyond the first fourteen hours) for children and youth, ages 3 through 20 years, who are not in state custody and for children and youth in foster care (ME Codes 07, 08, 37, and 38), not residing in a residential treatment facility. With the exception of diagnostic evaluation, precertification is required for all covered services (i.e., psychological testing and family therapy) provided to children age birth through 2 years, regardless of the ME code or placement of the child.
Precertification Requirements for Behavioral Health and ABA Services
Reminder of precertification requirements for behavioral health services, including psychotherapy and applied behavior analysis (ABA)
Effective immediately, all ABA services require precertification. Submitted claims for ABA services without a precertification will be denied.
Applied Behavioral Health Analysis (ABA) Billing - System Update
MO HealthNet Division (MHD) was recently made aware of ABA claim denials due to incorrect limit restrictions for CPT codes 97153 and 97155. MHD has implemented a system fix and as of October 28, 2022, claims are paying correctly. Providers may need to review claim denials based on limit restrictions for the CPT codes mentioned and rebill the claims for reimbursement.
Biopsychosocial Treatment of Obesity
MO HealthNet Division (MHD) covers Biopsychosocial Treatment of Obesity for youth and adults for dates of service on or after September 1, 2021.
Applied Behavior Analysis (ABA) Billing
Providers must use the appropriate modifier(s) when billing ABA services in order to ensure correct reimbursement.
Behavioral Health Precertification Refresher:
Behavioral Health providers may deliver 14 hours of psychotherapy services to a participant, each rolling year, in any combination of individual, family or group therapy (90832, 90834, 90837, 90846, 90847, or 90853).
If you provided individual, family, or group therapy to the participant in the last rolling year a precertification is required to continue services beyond the initial 14 hours.
All covered behavioral health services for participants under the age of 3 require precertification, with the exception of psychiatric diagnostic evaluation (90791, 90792).